Medical Society of the Missouri Valley. The spring meeting of this association will be held in Council Bluffs, Iowa, on Thursday and Friday, March 19 and 20. The membership of this society includes the representative men of Iowa, Nebraska, Missouri, Kansas, North and South Dakota, and the meetings are always interesting and profitable to those who attend. A feature of the first day's session will be a symposium on Syphilis, and on the second day a symposium on Typhoid Fever will be presented. The following papers have been promised: Hereditary_Syphilis, R. C. Moore, Omaha, Neb. Syphilitic Immunity; or Second Infection, A. C. Stokes, Omaha, Neb. Syphilis as Affecting the Nervous System, F. E. Coulter, Omaha, Neb. A Study of a Case of Dual Personality, S. Grover Burnett, Kansas City, Mo. Embryology, Histology and Pathology of the Eye (illustrated), Flavel B. Tiffany, Kansas City, Mo. Report of Uses of X-Ray in Chronic Eczema, Acne, Cancer, etc., W. L. Kenney, St. Joseph, Mo. The Psychologic Factor in Medicine and Its Application to Nervous Diseases, John Punton, Kansas City, Mo. A Few Cases of Loss of Cornea from Neglected Dacryocystitis, D. C. Bryant, Omaha, Neb. Orthopedic Surgery, Bloodless, Non-bloodless and Mechanical, Jas, W. Cokenower, Des Moines, Ia. Some Cases of Cured Appendicitis, Harry H. Everett, Lincoln, Neb. Insanity and Tuberculosis following Typhoid, and report of Two Unusual Cases, F. E. Walker, Worthington, Minn. Diseases Simulated by Typhoid Fever, D. T. Martin, Pomeroy, Ia. Congenital Syphilis in the Newborn and Young Infants, Mary Strong Omaha, Neb. Regular program will be issued March 1st. Titles should be sent to the secretary not later than February 15th, as the program is limited to twenty-five papers. A cordial invitation is extended to the profession. DR. J. M. BARSTOW, President, Council Bluffs, Ia. CHAS. WOOD FASSETT, Secretary, St. Joseph, Mo. XIV INTERNATIONAL MEDICAL CONGRESS AT MADRID.-It is believed that a considerable number of American physicians will visit the 14th International Medical Congress, to be held in Madrid, April 23-30, 1903. As all those who wish to attend the Congress have a common objective point, it is thought that they can be associated to advantage in one or more excursion parties. In this way the social features of the trip will be enhanced, and each individual will be surrounded by those who are personally congenial. By such association better accommodations can be secured and at a considerable reduction in price. Additional security will also be attained, as parts of the trip which include comparatively unfrequented routes of travel will be under the charge of a travelling conductor who is thoroughly conversant with the language and customs of the countries visited. As there will doubtless be some divergence as to choice of routes depending on individual inclination and previous opportunities of foreign travel, several returning routes have been selected, the itineraries of which, although separate from a portion of the journey, have been arranged that the principal points are visited together. The party will sail from New York City, on April 11th, on the twin-ocean steamer, "Princess Irene," North German Lloyd, direct to Gibraltar. Tickets for the round trip, including hotel and sight-seeing, $265 and $550, according to the tour selected. It is important that all who contemplate taking this trip should register at once, so that reservations for hotel in Madrid may be satisfactorily arranged. Final arrangements will be in the hands of the well-known conductors, Thos. Cook & Sons, which insures perfect and complete service in all details. Full information and copies of itinerary may be obtained by addressing either of the last named undersigned. Ramon Guiteras, 75 W. 55th St., New York City. Chas. Wood Fassett, Krug Park Place, St. Joseph, Mo. By the death of Mr. John Carnrick the ranks of the pioneer drug trade in the United States have lost their former leader. He was born in 1837, and at the age of 24, he took up the study of pharmacy in Jersey City, and was among the first to bring out proprietary medicines, together with the manufacturing of drugs for the physicians. Among these the first that came from his tutored hands was lactopeptine, followed by maltine, and later by liquid peptonoids and pancrobilin, as well as others not here enumerated, and as these were in line with the present medical inquiry, he still more closely devoted himself to this special pharmaceutical work, selling the general line of the drug business to Parke, Davis & Co., so that his time might be given wholly to research. Working along these lines, overcoming the faults of the old and bringing out new facts, which scientific research had brought to him, he developed protonuclein, peptenzyme and trophonine, which have received the world wide approbation of physicians. About five years ago feeling the strain of manufacturing with its untiring demands, he sought other lines and left the business in which he was so long associated and had become so well known to the profession. The old firm of Reed & Carnrick still retained his name, and by the instillation of new blood have brought to perfection his later products. While the name of John Carnrick is better known to the former generation, the children fed on lacto preparata, invalids on maltine; those in acute disease saved by protonuclein, and the dyspeptic cured by peptenzyme, all unite to praise their author, who, although not known to them, has raised the drug trade to its present high standard. THE MEDICAL SOCIETY OF THE STATE OF MISSOURI will hold its meeting at Excelsior Springs, April 21, 22, 23, one month earlier than usual, on account of the advanced date of the A. M. A. meeting at New Orleans. The Reviewer's Table.. Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis. INTERNATIONAL CLINICS. A Quarterly of Illustrated Clinical Lectures and especially prepared Articles on Medicine, Neurology, Surgery, Therapeutics, Obstetrics, Pediatrics, Pathology, Dermatology, Diseases of the Eye, Ear, Nose and Throat, and other Topics of Interest to Students and Practitioners by leading members of the Medical Profession throughout the World. Edited by Henry W. Cattell, A. M., M. D., Philadelphia, with the Collaboration of John B. Murphy, M. D., Chicago; Alexande Blackader, M. D., Montreal; H. C. Wood, M., Philadelphia; T. Rotch, M. D., Boston; E. Landolt, M... Paris: Thomas G. Morton, M. D., Philadelphia; James J. Walsh M. D., New Y89; J. v. Ballantyne, M. D., Edinburgh, and John Harold, M. D., London, with regular correspondents in Montreal, London Paris Leipsic and Vienna. Volume. II. Twelfth series. PhideRand London: J. B. Lippincott Company. 1902. (Cloth, $2.00 each.) This excellent volume presents the usual interesting series of lectures by eminent authorities in medicine and surgery. The medical section has ten lectures; the surgical five with several special lectures. The biographical sketch of this number considers Dr. Jno. B. Murphy. We are pleased with this feature of the work; it shows and tells us how other men work, teaches system and gives ideas that will inculcate good habits in practice. We hope that physicians will encourage this valuable addition to this very valuable work. We need to be familiar not only with practical medicine and surgery, but also with practical business methods and ways to succeed other than the purely professional knowledge of disease. The International Clinics are practical, hence valuable. F. P. N. SEVERAL years ago a suggestion was made to President Eliot of Harvard that, inasmuch as the first thing a young man ordinarily did on graduating from college was to chose his life-work, it was important that each student should have presented to him a thorough discussion as to the advantages, disadvantages and temptations of each of the leading professions, so that in determining his life-work he might act with the fullest knowledge attainable. The Cosmopolitan has begun this discussion in its January issue by taking up the legal profession. Besides pointing out. what the young man has to encounter in entering upon a lawyer's career, The Cosmopolitan considers at length the revolution which has taken place in the legal profession because of the reorganization of business in great aggregations like the U. S. Steel Corporation, and modern business instruments, such as trust companies, title and guarantee companies, and fidelity insurance companies. PAPERS for the Original Department should be in hand one month in advance, and contributed to THE MEDICAL FORTNIGHTLY exclusively. A liberal number of extra copies will be furnished authors, and reprints may be obtained at reasonable rates, if request accompanies the manuscript. Engravings from photographs furnished free. Contributions, and books for review, should be sent to the Editors, 318-320 Century Buliding, St. Louis. COLLABORATORS. ALBERT ABRAMS, M. D., San Francisco. ARTHUR R. EDWARDS, M. D., Chicago, Ill. Mr. REGINALD HARRISON, London, Eng RICHARD T. HEWLETT, M. D., London, Eng HOBART A. HARE, M. D., Philadelphia. J. E. JENNINGS, M. D., St. Louis, Mo. H. M. WHELPLEY, M. D., St. Louis. Diagnostic Points of Difference Between Spermatorrhea and Seminal Pollutions. BY F. R. STURGIS, M. D. NEW YORK CITY. Read before the Mississippi Valley Medical Association at Kansas City, Oct. 15, 1902. T occurred to me that a paper calling attention to the diagnostic points of difference between spermatorrhea and seminal pollutions, would be of interest; first, because this is a class of diseases which has IT been comparatively little worked over, indeed, has been rather slighted by the medical profession; and, second, because I have noticed in reading over the literature of the subject, which appears in medical journals, that there seems to be a confusion in the minds of medical men as to the nature of these two diseases. With the majority of doctors the two diseases seem to be convertible terms and practically the same. This, in my opinion, is decidedly wrong, and in consequence of this confusion the treatment of this class of diseases is uncertain and happygo-lucky, being rather empirical than based upon sound, scientific knowledge. In this paper I shall not attempt to present a natural history of these two diseases, except in so far as it may be necessary to elucidate the points which I wish to make, and these points I shall lay down as follows: rhea. First.-Spermatorrhea is a disease sui generis. Second.-Spermatorrhea has nothing in common with pollutions. Fifth.-Pollutions are liable to lead to impotence. For the purposes of this paper I shall not, of course, under pollutions, include the nocturnal variety, or, what is vulgarly termed, "wet dreams," but shall confine myself to a consideration of the diurnal forms of this type of the disease, where the losses are constant, and where the results are much more serious than they are in the nocturnal variety. 1. Spermatorrhea is a disease sui generis and has nothing in common with pollutions. In this class of sexual diseases the symptoms are so distinct that when its natural history is studied it will be noted that the seminal loss which occurs is not constant. It occurs occasionally and under certain conditions, and those conditions are chiefly of the class which requires some strong muscular or expulsive effort to produce the loss, thus, severe coughing, sneezing, straining-as at stool, or during the expulsive efforts in urination-as well as the effort made in lifting heavy objects, where the abdominal muscles are tense while respiration is suspended, are the usual conditions under which the seminal loss occurs, and it is associated, but not constantly so, with a sense of smarting and burning in the deep urethra. The patient is then aware that fluid is running along the course of his urethra, and this sensation is associated with a distinct feeling of depression, so marked that, as patients have expressed it to me, they feel as though they had been "let down." This depression is not only mental, but also physical, and may last anywhere from fifteen minutes to two or three hours before the patient entirely recovers his normal tone. At the end of this time the patient has entirely recovered from his attack, and feels practically as well as ever, having no sensation of mental depression or physical fatigue, nor any of the symptoms which would be grouped under the generic name of neurasthenia. This is one of the commonest of the causes which produce spermatorrhea; but it may also be caused at times by constipation, which induces the seminal loss, not as has been supposed because the hardened feces press upon the ejaculatory ducts or upon the vesiculae seminales, but because the fixation of the abdominal muscles, as well as the muscular effort necessary to expel the contents of the bowels, strip the seminal vesicles, much as a sponge is squeezed of the water which it may contain. But, oddly enough, the opposite condition may obtain and seminal losses may ensue with an attack of diarrhea, especially of that type known as "nervous diarrhea," but only where an irritation of the deeper portion of the canal is present. Now let us turn to pollutions and see what occurs in this type of disease. Here the seminal loss occurs without any effort whatever. It is purely a passive condition, increased, of course, if violent expulsive efforts are made; but in the more advanced type of the disease this is frequently absent, and the loss is a steady, continuous one, the seminal fluid |